Journal of Preventive Medicine and Public Health

Original Articles

The Impact of Household Economic Deterioration Caused by the COVID-19 Pandemic and Socioeconomic Status on Suicidal Behaviors in Adolescents: A Cross-sectional Study Using 2020 Korea Youth Risk Behavior Web-based Survey Data: Sanggu Kang, Yeri Jeong, Eun Hye Park, Seung-sik Hwang; J Prev Med Public Health. 2022;55(5):455-463. Published online September 12, 2022; DOI: https://doi.org/10.3961/jpmph.22.241

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Abstract Summary PDF Supplementary Material

Objectives
Economic hardship has a serious impact on adolescents’ mental health. The financial impact of the coronavirus disease 2019 (COVID-19) pandemic was more severe for low-income families, and this also impacted adolescents. This study aimed to examine the associations of economic deterioration (ED) caused by the COVID-19 pandemic and low socioeconomic status (SES) with adolescents’ suicidal behaviors.
Methods
This study analyzed data from the 2020 Korea Youth Risk Behavior Web-based Survey, which included 54 948 middle and high school students. Odds ratios (ORs) of suicidal ideation, suicidal planning, and suicide attempts related to ED and SES were calculated using multivariable logistic regression. We calculated relative excess risks due to interaction to assess additive interactions.
Results
The ORs for suicidal ideation, suicidal planning, and suicide attempts related to combined severe ED and low SES were 3.64 (95% confidence interval [CI], 3.13 to 4.23), 3.88 (95% CI, 3.09 to 4.88), and 4.27 (95% CI, 3.21 to 5.69), respectively.
Conclusions
ED and low SES were significantly associated with suicidal behaviors in adolescents. Although no significant additive interaction was found, the ORs related to suicidal ideation, suicidal planning, and suicide attempts were highest among adolescents from low-income families with severe ED. Special attention is needed for this group, considering the increased impact of economic inequality due to the COVID-19 pandemic.

Summary

Korean summary
청소년의 정신건강은 가정의 경제상황에 크게 영향을 받는다. 청소년건강행태조사(KYRBS)(2020)에 참여한 54948명의 중고등학생을 대상으로 가정의 기존 경제적 형편과 코로나19로 인한 가정경제 악화가 자살위험에 미치는 영향을 분석하였다. 그 결과 자살사고, 자살계획, 자살시도 모두 코로나19로 인한 경제상황 악화 정도가 심한 저소득층 가정 청소년에서 위험이 제일 높은 것으로 확인되었다. 코로나19(COVID-19)로 인해 심화된 경제적 불평등이 청소년 정신건강 불평등으로 이어지지 않게 하기 위한 개입이 필요하다.

Citations

Citations to this article as recorded by

Latent class analysis of health behaviors, anxiety, and suicidal behaviors among Korean adolescents
Mi-Sun Lee, Hooyeon Lee
Journal of Affective Disorders.2024; 354: 339. CrossRef
Letter to the Editor: Addressing Children’s Mental Health Issues Related to Economic Changes Caused by the COVID-19 Pandemic
Dalmacito A. Cordero
Journal of Preventive Medicine and Public Health.2023; 56(1): 95. CrossRef
Effects of COVID-19 outbreak on Korean adolescents: Impact of altered economic perception on physical activity, sedentary behavior, and stress levels in an age-, gender-, and BMI-matched study
Jisu Kim, In-Whi Hwang, Jeong-Hui Park, Youngdeok Kim, Jung-Min Lee, Sandra Celina Fernandes Fonseca
PLOS ONE.2023; 18(11): e0294270. CrossRef

Inequality in Private Health Care Expenditures: A 36-Year Trend Study of Iranian Households: Ehsan Aghapour, Mehdi Basakha, Seyed Hossein Mohaqeqi Kamal, Abolghasem Pourreza; J Prev Med Public Health. 2022;55(4):379-388. Published online June 27, 2022; DOI: https://doi.org/10.3961/jpmph.22.123

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Abstract PDF

Objectives
Throughout history, societies have been impacted by inequality. Many studies have been conducted on the topic more broadly, but only a few have investigated inequalities in out-of-pocket health payments (OHP). This study measures OHP inequality trends among the Iranian households.
Methods
This study used data from the Iranian Statistics Center on Iranian household income and expenditures. The analysis included a total of 995 300 households during the 36 years from 1984 to 2019. The Gini coefficient, Atkinson index, and Theil index were calculated for Iranian OHP.
Results
Average Iranian household OHP increased from 33 US dollar (USD) in 1984 to 47 USD in 2019. During this 36-year span, the average±standard deviation Gini coefficient for OHP was 0.73±0.04, and the Atkinson and Theil indexes were 0.68±0.05 and 1.14±0.29, respectively. The Gini coefficients for the subcategories of OHP of outpatient diagnostic services, medical assistant accessories, hospital inpatient services, and addiction cessation were 0.70, 0.61, 0.84, and 0.64, respectively.
Conclusions
In this study, we scrutinized trends of inequality in the OHP of Iranian households. Inequality in OHP decreased slightly over the past four decades. An analysis of trends among different subgroups revealed that affluent households, such as households with insurance coverage and households in higher income deciles, experienced higher inequality. Therefore, lower inequality in health care expenditures may be related to restricted access to health care services in Iran.

Summary

Citations

Citations to this article as recorded by

Decomposition of Healthcare Utilization Inequality in Iran: The Prominent Role of Health Literacy and Neighborhood Characteristics
Neda Soleimanvandiazar, Seyed Hossein Mohaqeqi Kamal, Mehdi Basakha, SalahEddin Karim, Sina Ahmadi, Gholamreza Ghaedamini Harouni, Homeira Sajjadi, Ameneh Setareh Forouzan
INQUIRY: The Journal of Health Care Organization, Provision, and Financing.2024;[Epub] CrossRef

Decomposition of Socioeconomic Inequality in Cardiovascular Disease Prevalence in the Adult Population: A Cohort-based Cross-sectional Study in Northwest Iran: Farhad Pourfarzi, Telma Zahirian Moghadam, Hamed Zandian; J Prev Med Public Health. 2022;55(3):297-306. Published online May 3, 2022; DOI: https://doi.org/10.3961/jpmph.22.051

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Abstract PDF Supplementary Material: Objectives
The incidence of cardiovascular disease (CVD) mortality is increasing in developing countries. This study aimed to decompose the socioeconomic inequality of CVD in Iran.
Methods
This cross-sectional population-based study was conducted on 20 519 adults who enrolled in the Ardabil Non-Communicable Disease cohort study. Principal component analysis and multivariable logistic regression were used, respectively, to estimate socioeconomic status and to describe the relationships between CVD prevalence and the explanatory variables. The relative concentration index, concentration curve, and Blinder-Oaxaca decomposition model were used to measure and decompose the socioeconomic inequality.
Results
The overall age-adjusted prevalence of CVD was 8.4% in northwest Iran. Multivariable logistic regression showed that older adults, overweight or obese adults, and people with hypertension and diabetes were more likely to have CVD. Moreover, people with low economic status were 38% more likely to have CVD than people with high economic status. The prevalence of CVD was mainly concentrated among the poor (concentration index, -0.077: 95% confidence interval, -0.103 to -0.060), and 78.66% of the gap between the poorest and richest groups was attributed to differences in the distribution of the explanatory variables included in the model.
Conclusions
The most important factors affecting inequality in CVD were old age, chronic illness (hypertension and diabetes), marital status, and socioeconomic status. This study documented stark inequality in the prevalence of CVD, wherein the poor were more affected than the rich. Therefore, it is necessary to implement policies to monitor, screen, and control CVD in poor people living in northwest Iran.; Summary

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